ATHENS, Pa. — Are you a small or mid-size farm or agri-business?
Do you want to offer health insurance to your employees but some of your employees do not want coverage making it difficult to meet the minimum participation requirements?
Do you have two or more employees that would enroll if you were to offer a health insurance plan?
Would your employees be interested in purchasing healthcare through work, even if you didn’t contribute or if you were to contribute less than 50%?
Does access to a group plan – which typically offers better pricing and provider networks than the “marketplace” – interest you?
If you answered yes to the questions above, Agri-Services Agency may have a solution. Below are some questions and answers about access to a special open enrollment period that could help. If you have questions or would like to discuss this, please don’t hesitate to contact us at 877-466-9089.
Q: What is considered a small farm or agri-business?
A: In healthcare terms, a small group is one that has between 2-50 employees in most states. In New York, California, Vermont and Colorado, a small group is defined as one with between 2-100 employees.
Q: What are the minimum requirements that insurance companies specify?
A: There are many requirements that health insurance companies place on small businesses. There are two, in particular, that can make it difficult for employers to offer healthcare benefits.
- Participation – Insurance companies typically require an employee participation rate of 75%. This can vary, but 75% is a fairly standard number.
- Contributions – Insurance companies often require employers to contribute at least 50% of the healthcare premium.
Q: How can we work around these minimum requirements?
A: There is a condition in the Affordable Care Act (ACA) that allows for these minimums to be waived. If you apply for small group coverage between November 15th and December 15th (for a policy effective date of January 1st), these minimum requirements are waived.
Q: What does this mean?
A: If you apply during the special open enrollment period (11/15 to 12/15), there are no minimums for participation or contribution. You can have as few as 2 employees enroll – no matter how many employees you have on your payroll. Additionally, you can contribute as much or as little as you want to the plan on your employee’s behalf, even as low as $0.
Q: Are there other requirements that must be met to take advantage of this special open enrollment?
A: There are some additional requirements, here are the most common, you must be a business eligible for group coverage, an owner only policy would not be considered a group (must have two or more employees), and there must be at least one common law employee collecting a W-2.
If offering health insurance to your employees is something that you would like to do, but the minimum requirements enforced by insurance companies have made it difficult, Agri-Services Agency may be able to help. Please contact our Customer Service Center at 800-466-9089.